A Multicenter, Feasibility Study Exploring Self-Administration of Chemotherapy in the Home Environment: The EASE Study.

BACKGROUND

Numerous studies have investigated the feasibility of home administration of bortezomib by nurses for the management of multiple myeloma. However, the impact of patient self-administration remains largely unexplored.

OBJECTIVE

The objective of this study was to evaluate the impact and feasibility of patient self-administration of subcutaneous bortezomib.

METHODS

This prospective feasibility study aimed to assess the efficacy and safety of this intervention as well as quantify the impact on patients and their caregivers. Patient and caregiver satisfaction were assessed using validated questionnaires at monthly intervals. An analysis of both direct system and indirect patient costs was also conducted.

RESULTS

Thirty-four patients received 1194 doses of bortezomib for self-administration over the study period. Patient self-administration was determined to have minimal impact of treatment efficacy, and with only 8 grade 3 higher adverse events occurring, there was no effect on safety since none were due to patient self-administration. Patient satisfaction with the intervention was highly rated with 99% of responses indicating that the patient would choose this clinic again. Caregiver quality of life remained stable for the duration of the intervention. Institutional cost savings totaled an estimated $CAD 1 800 000 over the trial period, while patients collectively saved an estimated $CAD 23 000.

CONCLUSION AND RELEVANCE: Patient self-administration of bortezomib is efficacious, safe, cost effective, and was well received by both patients and caregivers.